Infertility: Why It’s Not Just a Woman’s Concern

It’s often thought that infertility is a “woman’s problem,” but the truth is both men and women can experience fertility issues. In fact, one-third of infertility cases are due to male factor infertility. In this article, we explore some common questions surrounding male infertility including causes, diagnoses, and how to seek help.

How Is Male Infertility Diagnosed?

Couples often try to conceive for years before seeking help. But current recommendations state you may be able to seek help sooner than you think. Guidelines suggest that couples under the age of 35 who have been unsuccessfully trying for one year should meet with a fertility specialist, and couples over 35 can seek help after just six months.

To test for male infertility, a fertility specialist will conduct a semen analysis. A semen analysis looks at various factors that can impact male fertility such as sperm count, motility, volume, and morphology. We’ll get into what each of these means below.

What’s Involved in a Semen Analysis?

During a semen analysis, a healthcare provider will examine the specimen in a lab under a microscope to identify anything abnormal. Some key factors they will evaluate include:

• Sperm count: Overall quantity of viable sperm. A low sperm count is considered under 15 million per sample. While the number may seem large, the normal count is between 15 – 200 million.
• Motility: Ability for the sperm to move properly. If the sperm does not swim appropriately, this will make it difficult or impossible for it to travel through the fallopian tubes and reach the egg for fertilization.
• Morphology: Size and shape of the sperm. Sperm need to have a normally shaped head to penetrate the egg and fertilize.

It’s important to provide a clean sample, so a man will be asked to collect a small specimen in a sterile container provided by the office. It’s often recommended that he abstain from sex for 2-5 days before performing the test to ensure sperm count is at its highest level. Once collected, the specimen will need to be delivered to the office within one hour. It is also recommended that you keep the specimen at body temperature to maintain the motility and viability of the sperm cells.

How Can Male Infertility Be Treated?

For couples who have received a diagnosis of male factor infertility, there are still options to conceive!

In some cases, lifestyle may play a role in the diagnosis, so it’s recommended to avoid smoking, limit alcohol, and eat a healthy diet. Overall, it’s important to understand the root cause in order to find the proper treatment. A meeting with a urologist can help identify the cause and determine the proper treatment, which may include medication or surgery.

Assisted reproductive technology is also a common solution to addressing male factor infertility.

One type of procedure is called an intracytoplasmic sperm injection (ICSI) and is performed in combination with in vitro fertilization. This involves a skilled embryologist carefully selecting one, perfect sperm and manually injecting it into the egg, greatly increasing the rate of fertilization. For this to happen, the female partner has to undergo the full IVF process, even if she has no fertility diagnosis of her own.

Another treatment is intrauterine insemination (IUI), which is often an option for less severe cases. This is where a provider takes the sperm sample, washes it to keep only the best swimmers, and places the sample directly into the uterus in hopes of achieving a successful pregnancy.

The first step in treating male factor infertility is recognizing it can be an issue. While many women have publicly come forward to share their infertility journeys, men’s experiences still largely remain in the shadows. With greater awareness, there is hope that we can reduce the stigma of male factor infertility.

A reproductive endocrinologist trained in supporting couples with infertility can help you to explore your options. Our fertility partners are here to help you through each step!